I called my health insurance carrier because I received a letter stating I was eligible to continue my health care coverage on an individual policy when my COBRA terminates in 2 months. It was mailed to my home address in Great Big State. With hope I called to initiate this conversion. After giving my name, social security number, and home address, I was told "you are not eligible."
"Well, then why does the letter say that I am eligible?" I replied.
"I don't know but you live in Big State. Any one who lives there is not eligible." said the voice on the other end of the line.
"Well your company mailed me this letter, to my home address in Big State. Did someone at your company think I did not live in Big State, I mean, I have been receiving bills and making payments from this address for the last 16 months?" I asked.
"I don't know about that but you are not eligible, I don't care what the letter you have says."
Who do I believe? The person who mailed the letter or the one on the telephone. I can tell you this, after searching for health insurance for over a year, there is not an honest person out there associated with an insurance company. The insurance industry holds are the cards and the Affortable Health Care Act dealt them a sweet hand. While health care is now becoming a requirement, I am not sure it is something the middle class will be able to afford.
Until this country is ready to do something about the insurance industry who has the largest lobby in both Washington DC and your local state house, they will continue to take our money and work hard not to pay for care.
Tuesday, August 31, 2010
Monday, August 23, 2010
Changing the world
Since it is Monday and the beginning of a new school year for many, I am thinking about the impact each of us has on the world. When I was younger, middle school and high school, my greatest desire was to make some world changing discovery. A cure for a deadly disease or an invention to ease human suffering was my goal.
With time and age, by about my second year of college, I realized these types of discoveries where a combination of brilliance and luck. Since I possessed neither in large quantities, I settled down to the slow, grinding task of preparing myself for medical school. In another couple of years, I realized that some combination of brilliance and luck were required for medical school admission also. Since I was short on the first, I would have to say it was the second of those two commodities which landed me in that now Well-Known Medical College of the south.
Getting back to change, it seems it comes in one of two forms. Change is either slow and insidious, something we are not able to appreciate in our life time. A physical example of this is the Grand Canyon. Or change is cataclysmic, the death of the dinosaurs (and many other forms of life) in a short span of time.
In the last 18 months, I have learned I am not going to have any type of meteoric change on the health care system, even in Major Metropolitan City. Hopefully, however, I am making some type of difference in the landscape, at least where the lives of my patients and colleagues are concerned.
With time and age, by about my second year of college, I realized these types of discoveries where a combination of brilliance and luck. Since I possessed neither in large quantities, I settled down to the slow, grinding task of preparing myself for medical school. In another couple of years, I realized that some combination of brilliance and luck were required for medical school admission also. Since I was short on the first, I would have to say it was the second of those two commodities which landed me in that now Well-Known Medical College of the south.
Getting back to change, it seems it comes in one of two forms. Change is either slow and insidious, something we are not able to appreciate in our life time. A physical example of this is the Grand Canyon. Or change is cataclysmic, the death of the dinosaurs (and many other forms of life) in a short span of time.
In the last 18 months, I have learned I am not going to have any type of meteoric change on the health care system, even in Major Metropolitan City. Hopefully, however, I am making some type of difference in the landscape, at least where the lives of my patients and colleagues are concerned.
Wednesday, August 18, 2010
American medical care
Two months ago I saw a woman who was employed and has insurance, both medical and disability through her employer. I am not implying I never see patients like this any more but this woman was not really ill enough to be in the hospital. She and her husband moved to a community south of the Metropolis 6 months ago from another state. For reasons I will not go into her that community does not have women's services at their hospital.
She woke up on a Saturday morning with some mild pain which increased over the day. Having no physician to call, she went to the local emergency room. With no gynecologist to refer to, the ER physician got out his protocol book and began ordering tests. Pregnancy test was negative, white blood count was normal, ag. ain she really was not sick, but the next step was a sonogram.
When the sonogram was done by the technician, who was called in from home, she informed the ER physician that the radiologist would read it on Monday. The sonogram did, however, show something abnormal in the region of the right ovary. Hearing this the ER physician called the ER physician at my hospital. The result was the transfer of this woman, by ambulance, 45 miles to the hospital where I was on-call. No one told me about the patient until she arrived in the emergency room at my hospital 5 hours later. By this time it is 1 AM on Sunday morning.
Seeing the patient, reviewing her laboratory values and her sonogram, I explained to her that she had a hemorrhagic corpus luteum cyst or a blood clot on her ovary from ovulation, which had grown slightly larger than normal, probably causing the pain she had the day before but had now resolved. Her blood counts had been repeated by the ER doctor at my hospital. He needed to have something to do and bill for, right. These tests were all stable and now she was pain free.
Her husband was there. He had followed the ambulance to be with her. Following my exam and review of all that had been done, both were relieved to find out it was nothing serious. They packed up and went home. I gave her a follow up appointment in my post op clinic the next week to make sure she was feeling OK along with the names of several gynecologist who have practices in the area.
When I saw this woman 4 days later, she was doing great. She had an appointment in a couple of weeks with her new gynecologist AND she had four or five pages of paper work for me to fill out to get the ER visits and the ambulance ride paid for. I did my best.
And why am I bringing this story up now. Well, at the time I thought about how pointless all this was. Her pain resolved with a little bit of time and not much else but she got several thousand dollars worth of tests. I am now really irritated because I am still filling out paper work for the expensive items: sonogram and ambulance ride while I have little hope of being paid for my part in her care.
She woke up on a Saturday morning with some mild pain which increased over the day. Having no physician to call, she went to the local emergency room. With no gynecologist to refer to, the ER physician got out his protocol book and began ordering tests. Pregnancy test was negative, white blood count was normal, ag. ain she really was not sick, but the next step was a sonogram.
When the sonogram was done by the technician, who was called in from home, she informed the ER physician that the radiologist would read it on Monday. The sonogram did, however, show something abnormal in the region of the right ovary. Hearing this the ER physician called the ER physician at my hospital. The result was the transfer of this woman, by ambulance, 45 miles to the hospital where I was on-call. No one told me about the patient until she arrived in the emergency room at my hospital 5 hours later. By this time it is 1 AM on Sunday morning.
Seeing the patient, reviewing her laboratory values and her sonogram, I explained to her that she had a hemorrhagic corpus luteum cyst or a blood clot on her ovary from ovulation, which had grown slightly larger than normal, probably causing the pain she had the day before but had now resolved. Her blood counts had been repeated by the ER doctor at my hospital. He needed to have something to do and bill for, right. These tests were all stable and now she was pain free.
Her husband was there. He had followed the ambulance to be with her. Following my exam and review of all that had been done, both were relieved to find out it was nothing serious. They packed up and went home. I gave her a follow up appointment in my post op clinic the next week to make sure she was feeling OK along with the names of several gynecologist who have practices in the area.
When I saw this woman 4 days later, she was doing great. She had an appointment in a couple of weeks with her new gynecologist AND she had four or five pages of paper work for me to fill out to get the ER visits and the ambulance ride paid for. I did my best.
And why am I bringing this story up now. Well, at the time I thought about how pointless all this was. Her pain resolved with a little bit of time and not much else but she got several thousand dollars worth of tests. I am now really irritated because I am still filling out paper work for the expensive items: sonogram and ambulance ride while I have little hope of being paid for my part in her care.
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